3. Development of chest pain centers

Chest pain centers developed as a strategy to reduce mortality and morbidity from myocardial infarction and to educate the public on the benefits of seeking help when chest pain first occurs [11-13]. Consequently, chest pain centers focused initially on 'fast-track' protocols, developed to rapidly and accurately diagnosis and treat patients with an infarction and administer thrombolytic therapy, with the target of a 30-min door-to-needle time. Since up to 70% of coronary care patients are discharged without a myocardial infarction, chest pain centers offered a lower cost facility that provided thorough evaluation, using standardized protocols to avoid inappropriate discharge. Finally, both goals of the chest pain centers were supported by an underlying strategy to educate the community about heart attacks, how to recognize the early warning signs of an impending infarction and when to seek help. Community education is a critical factor in reducing morbidity and mortality since the 'heart' of the heart attack problem is in the community [21].

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